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P Backlar

Publications and source records attributed to P Backlar.

At least 19 recordsLinked to original sources
PubMed2001

Consumer, provider, and informal caregiver opinions on psychiatric advance directives.

Psychiatric advance directives (PADs) are legal documents that permit competent adults to make choices in the present about their future psychiatric treatment if they lose their decision-making capacity. PADs may provide for the appointment of surrogate decision-makers. The present project was undertaken to obtain opinions from the consumer (the patient), provider, and informal caregiver/surrogate about the Oregon PAD. Results of this pilot study show that the majority of no-PAD group consumers reported that they did not get enough help with PAD preparation. The PAD group consumers reported feeling empowered by PAD preparation, but at the follow-up interview, they were less enthusiastic and more critical of PAD policy that was relevant to implementation. Many providers also were concerned about successful PAD implementation. PAD legislation alone does not translate into adequate policy.

Adult↗
PubMed2000

Psychiatric advance directives: an alternative to coercive treatment?

Psychiatric Advance Directives (PADs) are a legal means by which persons with mental illness, while competent to make healthcare decisions, may specify their preferences for treatment and may designate a surrogate decision-maker to act on their behalf in the event of an incapacitating mental health crisis. PADs have been advocated as a strategy to increase autonomy and decrease coercion in the treatment of severe psychiatric illness, but there has been little research on the actual use and effects of PADs. This article develops a conceptual model for how PADs might work, both directly and indirectly. According to the model proposed here, PADs might provide an effective tool for managing psychiatric crises but might also help to improve participation in regular outpatient treatment. This article further examines arguments for and against PADs and looks optimistically toward their use as an alternative to more coercive approaches to mental health treatment such as outpatient commitment (OPC).

Advance Directives↗
PubMed1998

Advance directives for subjects of research who have fluctuating cognitive impairments due to psychotic disorders (such as schizophrenia).

Current and coincident biomedical advances make this an opportune time to encourage research with subjects who have fluctuating cognitive impairments due to disorders like schizophrenia. Effecting research with a heterogeneous population who may have impaired decision-making capacity that diminishes their autonomy, while honoring their liberty and safeguarding their wellbeing, entails a rigorous moral charge. Federal regulations and guidelines in regard to research involving this population are insufficient and make for additional obstacles. Use of research advance directives that allow for the appointment of surrogate decision-makers and delineate safeguards for the research subjects may afford protection both for subjects and researchers.

Advance Directives↗
PubMed1998

Justice for all?

Explore the source record for details and available documents.

Community Health Services↗
PubMed1998

Anticipatory planning for research participants with psychotic disorders like schizophrenia.

Current and coincident biomedical advances make this an opportune time to encourage research with individuals who have fluctuating periods of incapacity caused by psychotic disorders like schizophrenia. Effecting research with this heterogeneous population who may have impaired decision-making capacity that diminishes their autonomy, while honoring their liberty and safeguarding their well-being, may be difficult to achieve. Federal regulations and guidelines in regard to research with this population are insufficient and cause additional obstacles. Use of research advance directives that allow for the appointment of a surrogate decision maker, the designation of a research monitor, and delineation of specific safeguards for the research participants also may provide protection for investigators and foster and improve community trust in medical research.

Advance Directives↗